How can we help regulators stay connected to the person-centred aspects of their work?
08 May 2024
How can we improve the experience of witnesses in fitness to practise proceedings, and humanise healthcare regulation?
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Health professional regulators play a fundamental role in protecting the public. They are responsible for setting the education and practice standards required to join the relevant professional register, and for ensuring everyone on the register is fit to practise.
Six years ago, I started working with the Nursing and Midwifery Council (NMC) as their Head of Public Support. The role was created in direct response to the Nursing and Midwifery Council’s handling of concerns about midwives’ fitness to practise at the Furness General Hospital. Essential to my work was the direct involvement of patients and families – to help understand how they had experienced the NMC, and how things could be improved.
My first task was to set up a public support service. This centred on an in-house team to provide end-to-end support for members of the public who were involved in the process of assessing the fitness to practise of nurses and midwives, an independent support line, and a support advocacy framework for those who find it hard to have their voices and experiences heard.
More recently, in my role as CEO of the Point of Care, I have been involved as a public adviser to the Witness to Harm: Improving patient, family and colleague witnesses’ experiences of Fitness to Practise proceedings study. And I was recently invited to share my views on compassionate regulation at a General Medical Council (GMC) ‘brown bag lunch’ event with 140 members of staff.
This has caused me again to consider the need for person-centred and more human regulation. One question still resonates with me: if the relevant regulatory codes of practice require professionals to deliver person-centred care, how can we help regulators remain connected to the human aspects of their industries and regulate with compassion?
The role of the regulator in human-centred care
It is interesting to consider the role of the regulator in ensuring human-centred and compassionate care is delivered. Regulators are one step removed from the delivery of care, yet they exist to uphold standards on behalf of patients and families.
Fitness to practise proceedings are made up of many distinct and important processes that need to be followed carefully to ensure registrants are treated fairly and standards are upheld in the interest of public protection.
However, these proceedings can be emotionally painful for individuals who may have to recount repeatedly their experiences of care, reliving the trauma of an event. If too great a focus is placed on adhering to procedural processes, there’s a risk of causing more harm.
Schwartz Rounds
At the GMC lunch event I attended, it was clear there is an appetite for work to help make regulation more compassionate. One of the attendees I met commented that “It was good to hear that there are ways of digging down into how exactly individuals within organisations, and therefore organisations, are helped to become more compassionate”. Another pointed out the value of “a reminder that outside of process and procedures there is a human element to the work that we do”.
So, how can we help regulators regulate with compassion?
One option to consider is implementing Schwartz Rounds in regulatory settings. Schwartz Rounds are open and safe spaces for colleagues (across all levels and disciplines) to discuss the more human aspects of their work. Schwartz Rounds help attendees recognise the challenging times as well as the positive moments. By sharing stories and experiences, Schwartz Rounds can also reduce hierarchies and help staff to focus attention on the relational aspects of their work.
We are proud to report that Schwartz Rounds are currently taking place in over 250 health and social care organisations across the UK and Ireland.
We know that we cannot show compassion to others if we do not feel compassion towards ourselves. By establishing Schwartz Rounds in regulatory settings, we can help support a culture of compassionate regulation.